This study evaluates the cost-effectiveness of expanding the Older Americans Act Elderly Nutrition Program (ENP) to include breakfast as a second home-delivered meal. The objective is to: 1) determine the beneficial effects on nutritional well being, quality of life, and healthcare utilization of program participants beyond those achieved by the current ENP program. 2) Compare program costs to participant benefits and to cost- savings in health-care services. The study will be structured as a cross-sectional field design with two treatment groups, each with 200 randomized participants. The intervention group will have been receiving a home delivered breakfast in addition to the noon meal, for a minimum of six-months. The control group will have been receiving the noon meal for a minimum of six-months. Participants will be recruited from the population of frail homebound older adults served by 7-10 racially/ethnically and geographically diverse cooperating agencies currently administering traditional and expanded ENP home-delivered meal programs. A comprehensive questionnaire covering demographics, nutritional status, health-related quality of life, hospitalization or institutionalization within the past 6 months, weight, use of supportive in-home services, and program satisfaction will be completed by participants. Service cost and menu information will be collected from agency contacts. This will be the first time that the ENP breakfast service will be evaluated in terms of cost influencing malnutrition, quality of life, and health care utilization. Results will determine whether the new program warrants promotion as a national model.